The subject is very complicated. In the state of Tennessee the state government has a program called TennCare for the poor. If you do not have insurance, TennCare will pay for everything. It is socialized medicine and it is expensive. The governor who passed thinks he is a saint. The poor jumped on it and TennCare pays out the nose.
Anyway, I have excellent health insurance. But actually, no one in Tennessee does not have medical insurance.
I am so sorry for what you have gone through and the stress it continues to cause as you try to find reasonable care. Your story is why we need something elseā¦beyond the Affordable Care Act, charity, insurance company managed healthcare. It is illegal to sell anything that requires a prescription but some things do not = over-the-counter insulins, test strips, etc. Someone can also GIVE you supplies. I have given supplies to my Drās office and they give them to people who need the supplies. I also wonder if some states allow you to buy rapid-acting insulins w/o a script. MO used to and now you need a script. Before going on a pump decades ago - shortly after diagnosis, I began multiple shots using Regular and long-acting insulin. I think UL is no longer available (replaced by designer long-acting insulins requiring a script). You could use NPH. I would work w/ a clinic Dr. or RN to get you started on a multiple shot regimen until you can get coverage.
If there is anything I can do to helpā¦message me here on Tu. It will not be a permanent fix but, could be temporary help. Never feel alone - we all struggle with this disease and some of us have had to struggle with economic and social stress associated w/ living with the disease. Big hug!
Marps, I know you were one of the lucky ones to participate in MGH trials. Hope you are doing greatā¦and may not need to be thinking about your T1 so much 
Hard to believe the first post dates back almost 7 years!
My insurance (CVS / Caremark) just dropped Humalog from the formulary. Apparently it costs more than Novolog and they want to save money.
How much money is saved?
31 cents a bottle
Humalog 10 mL U-100 = $240.06
Novolog 10 mL U-100 = $239.75
and just FYI
Lantus 10mL = $251.69
Hey - my insurance keeps trying to push me in the opposite directions - toward Humalog over Novolog or Apidra, and the cost they report for Humalog is MORE than for either of the other two! AND, they give me a lower copay for the more expensive Humalog over the othersā¦ Of course, those āpublished pricesā (in EOBs, etc.) are just for show. Who knows what the REAL costs are. Iām thinking the deals are more āIāll give you a discount on this other popular drug, if you push people to use this other one I want to sellā¦ā
Regardless - the only ones NOT part of the conversation are the patients, who are supposedly the customers.
Note: Due to bad reactions (allergy?) I cannot use Humalog. I think Iām becoming allergic to insurance companies, tooā¦
Hi Brian - I just started on the Caremark pharmacy benefit on January 1. When my doctor ordered for me a 90-day supply of Apidra, Caremark required a pre-authorization form filled out by my doctor. Since Iāve had a long-standing note in my medical records about an infusion site allergy to Novolog, Caremark filled the order for Apidra.
So, an allergy to Novolog meets their requirements for an exception to their preferred formulary of Novolog. I would have no moral compunction to using this fact to my advantage. If allergy is one reasonable basis for avoiding their choice of your insulin, Iām sure there are others. Perhaps there are other readers of this thread that know other plausible and effective grounds to make your choice the determinative one.
I think that managing diabetes is a tough job and the failure rate is very high. We all differ physiologically and if we find one brand better suited to help us manage diabetes, that personal conclusion should overrule every other concern, especially one driven by outsized corporate profitability margins!
Terry-
The only problem with getting the Humalog covered is that it would end up being a Tier III cost - which would be $250 for three monthsā¦instead of Tier II which is $125 for three months.
And with the Lantus and test strips also at Tier II cost of $125 for three monthsā¦my costs have gone from 3 x $50 for three months a few years ago to most likely $125 + $125 + $250 = $500 for three months this year. So - a 10x increase for the prescriptions that simply keep me alive. Nothing changed in the technology to make these better for me - they are exactly the same. The Affordable Care Act has not made simply staying alive any more affordable for me.
Did I mention I have a daughter with type 1 as well? Multiply those costs by 2x.
My wallet hurts.
I agree that the Affordable Care Act has, at best, made healthcare more affordable to insurance companies, but certainly not to consumers of healthcare ā and for āregularā consumers of healthcare who manages chronic conditions it can almost be eliminate the āproblemā thru financial destruction (ā¦of course, then we could all end up on Medicaid and have at least life-preserving treatment coveredā¦).
I donāt agree with your math, however @Brian28. Three times $50 (or $150) vs. $500 for three months is a 3.33 times increase (333 percent), not 10x. 
so i found out, how much. my will be, with-out insurance, about $200 for one vial,.
Thas - you are of course correct. My math was very faulty. Sorry!
And now rememberingā¦Back in the 1980s, beef/pork R and NPH insulins were ~$12 a bottle. Not as effective as the rDNA insulins todayā¦but much more affordable.
@Brian28 ā Beyond any math errors, itās just plain wrong that any social policy sets up people with a life threatening illness be forced to make fat cats fatter. The greed of Big Pharma is disgusting. We in the US pay a lot more for health care access than the rest of the industrialized world yet receive worse results.
And the political āfixesā just keep making it worse
May be true in some cases like insulin , but not all APIās. Some of the drugs do take $$$ for research , trials and no guarantee it will hit the market.
One of the other reasons in US is every one is litigation happy and there are so many ambulance chasersā¦They drag down everything else with them and add the overhead
I get upset when people demonize pharmaceutical companies. I am just so tired of the āthe pharma companies are only out for profitā statements that can only be supported by anecdotal evidence. Itās the same sort of rhetoric that some people use to dehumanize another group of people so that it becomes easy to hate them and eventually hurt them. Companies are not living things. They are operated by people. Human beings. When you say āABC Pharmaā is greedy you are throwing everyone who works at āABC Pharmaā under the bus.
#Big Pharma
Some pharma companies are run by people who care only for maximizing profit. Some are run by people who really care. Iāve worked in the pharma industry and Iāve met the scientist and the sales people and business people and the IT people who work in the industry. These are people who are my friends and neighbours. The people I know are truly motivated to bring treatments to market that can help people. They personally know someone suffering from diabetes or cancer etc. They do their best to keep costs low and brings drugs to market as fast as possible. Iāve had the opportunity during the 10 years I worked in pharma to see a few drugs go from promising compond to clinical trials to market delivery. Iāve seen the cost associated with doing the research and clinical trials and manufacturing. Iāve seen what happens when some drugs donāt make it past clinical trials and are shelved. Money spent down the drain. Iāve personally experienced what happens when drugs lose their patents and the company doesnāt anything to make up for it. I ā along with almost a thousand of my peers ā had my role eliminated (information security manager) in because the drop in sales in 2013 due to the loss of a patent was so huge the company had a cash flow problem. Then 6 months after that the company announced that it was moving 800 jobs from the area to Tampa, FL as another cost cutting move. Labour costs in Tampa are 45% than in the Princeton, New Jersey area.
There are some inconvenient truths we need to address. The business of healthcare is a business. Pharmaceutical companies are in the business of making drugs/products for profit. Any business that doesnāt make profit isnāt viable. It takes time and money to research a drug. It takes money to do clinical trials. Assuming you get that far, it takes money to build a plant to safely make that drug. Sometimes the drug works out and sometimes it does not. At the end of the year, the business needs to make more money then it spent. Otherwise that business is not viable. If the situation continues, the business ceases to exists. Some of the profit must be set aside to help fund future endeavors. Some of the money goes back to investors who would not invest if the business was not viable. Perhaps someone can point me to a successful non-profit pharmaceutical company?
I am not trying to defend the pharmaceutical industry. I am asking that we stop vilifying the whole industry out of ignorance of how they actually operate or how much money they actually make. Before you spew invective, take a look at the publicly avaible financial information for the pharma companies. Then form an opinion.
NOTE: I am an independent information security consultant. I pay my own insurance costs. Itās about $33,000/year for the four of us. CGMS supplies are covered at 50%. Insulin and other supplies are covered at 90%.
Hah. How long has humalog been commercially available? Those costs of research, design, approval, compliance, manufacturing, plus a healthy profit margin were covered many many years ago-- but the price keeps tremendously outpacing inflation, for 20 year old technology. I wish I could sell my 20 year old truck for 10x what it cost brand new-- maybe I could if peopleās lives depended on buying it and every other person with a vehicle for sale in the world colluded to raise prices with me, and a third party was paying for it.
Of course there are good solid individual people doing good work at these companies. But their business practices as a whole are not something I find admirable.
Research. I really donāt like rhetoric. Itās designed to block communication and the actual search for an answer.
Links:
Why Insulin Costs So Much ~ David Mendosa
Understanding Insulin Sticker-Shock
Insulin Delivery Systems Market Analysis (2008-2012)
The Biosimilar Promise of Less Expensive Insulin
Unpacking the Rising Cost of Insulin and What it Means for Patients
How long has humalog been commercially available?
I donāt know. Why does it matter? Water is a naturally occurring substance that has been around for a few trillion years tād yet people pay lots of money for bottled water. How is the length of time that Homalog has been available relevant to its current price?
I wish I could sell my 20 year old truck for 10x what it cost brand new
In 2014, a working copy of the first computer model Apple ever sold, the Apple 1 from the 1970ās, sold at auction for over $905,000 dollars. Maybe your truck will sell for that much if you keep and maintain it well for another 20 years. I know there is a show about really old cars that sell for lots of money. But, I donāt see how this is relevant to drug pricing.
But their business practices as a whole are not something I find admirable.
Which business practices?
maybe I could if peopleās lives depended on buying it and every other person with a vehicle for sale in the world colluded to raise prices with me, and a third party was paying for it.
These are the statements I am asking people to avoid. Itās so easy to toss that out there with zero evidence and youāll get a lot of people to agree with you.
I certainly want to discuss the issue of healthcare cost but I want the discourse to be above the visceral.
Regretfully, you donāt get to tell people what to avoid saying.
From your second link-- "Whatās driving insulin price increases is a complex question with many answers. One factor that can be ruled out is the basic price of producing insulin. Ever since pharma companies mastered the technique of using bacteria to create synthetic analog insulin in the eighties, the cost of insulin production has remained relatively affordable. "
" Sanofi maintains the dominant market share on long-acting insulin and can dictate price, Kliff says."
"āLetās be honest, they have a near monopoly on the market,ā he says.
Many diabetes industry watchers have long held the belief that insulin-producing drug companies are driving up insulin prices simply because they can. That may be an oversimplification, but there is some truth that drug companies are using price increases on everyday drugs like high blood pressure medication and insulin to counter a drop in overall drug sales. Pharma executives admitted this as far back as 2011 during a Reuters Health Summit. And according to the Bloomberg report, U.S. drug spending declined by as much as 2% in the first half of 2013, giving space for insurance companies to be more lenient with price hikes in insulin."
Did you read these, Khurt?
Also this:
Regretfully, you donāt get to tell people what to avoid saying.
I didnāt TELL anyone to avoid anything. I used the word ASK.
Did you read these, Kurt?
Yes I did. I provided the links. My name is Khurt. I raise my consulting prices yearly. Why? Because I can.
Which is why Iām not even remotely interested in your consulting services-- I have no choice but to purchase insulin. Sorry for misspelling your name, Autocorrect insists that your name is Kurt-- blame Siri.